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A new vision for convenient surgery

aract patients can now save hours of driving time by having their surgery done right in Madras at Mountain View Hospital. Through an arrangement between American Eye Instruments Inc. (AEI), Mountain View, and Bend eye surgeon Dr. Micheal Stauder, the procedure will be available locally on a monthly basis. The AEI company provides specialized surgical machines, the hospital provides the surgery room, nurses and patient care, and doctor does the driving instead of the patient. Madras resident Sidney Green, one of the first patients, indicated he liked the new arrangement, as he was getting ready to go into surgery last Thursday morning. "It's wonderful. I had my other eye done in Bend by the same doctor. But I didn't have to get up near so early this morning to come here," Green said. Previously, cataract patients had to travel to Bend as many as seven times for pre-operative and post-operative visits and the surgery. The cataract surgery done at Mountain View is the same quality as that done at St. Charles Medical Center in Bend, Dr. Stauder emphasized. "It's a real portable surgery and it's not lower quality. It's the same equipment and the same doctor as in Bend," he observed. Randy Skinner, AEI manager, explained how the system works. The AEI company, based in Gold Beach, Ore., has been providing cataract surgery equipment since 1985 and services hospitals all across the U.S. He said the company was started by two optometrists who practice in small rural communities. "They designed the program to allow people to have the surgery in their own hometown instead of having to travel up to 100 miles to surgery centers," Skinner said. When cataract surgeries are scheduled, AEI technicians arrive in a van transporting a surgery microscope, a "phacoemulsification" machine, laser, and other eye surgery equipment and supplies that small community hospitals typically do not have. "The company provides equipment for between 2,000 and 3,000 surgeries a year," Skinner said, noting, "Next week I'll be in Tennessee and Virginia." As program manager he travels widely, while technicians work within a given area, he said. "It's a neat job. You're out there helping people and get to meet so many nice, down-to-earth people in small towns across the country," Skinner remarked. Many people have cataract surgery confused with cornea transplant surgery, but they are two different procedures. Cataract surgery involves the lens of the eye, located behind the eye's colored iris. As people age, the lens can get ridged, cloudy and distorted which interferes with vision. During cataract surgery, the cloudy natural lens of the eye is removed and replaced with a clear synthetic lens. Dr. Stauder performs the surgery under a microscope and uses AEI's phacoemulsification machine to remove the defective lens. "It uses ultrasonic energy to drive a handpiece with a tip that vibrates 40,000 times a second to break up and remove the cataract," Dr. Stauder said. Using only a 3 millimeter incision (about 1/8-inch), he then inserts a folded-up lens implant and unfolds it in the eye. "The incision is so small that it doesn't require stitches," Dr. Stauder said, noting before the ultrasonic method was available, surgeons had to make a 6 millimeter incision to remove cataracts. Only one eye is done at a time, with the patient returning several weeks later for the second surgery. The procedure takes only 20 to 30 minutes and costs range from $3,000 to $3,500 for the hospital, and $1,100 to $1,400 for the surgeon. Most cataract patients are over age 65 and Medicare with a supplemental insurance pays nearly all of the cost. Locally, optometrists Dr. Curtis Dix and Dr. Steve Evers refer the bulk of the patients to Dr. Stauder for the cataract program, but referrals can also made by other area doctors, Skinner said. Dr. Stauder agreed to travel to outlying hospitals because of patient requests. "I heard a lot of patients saying they wanted to have surgery done in their own hometowns because traveling was hard for them," he said. On Thursday Dr. Stauder had three surgeries at Mountain View Hospital and is planning to visit the Madras and Prineville hospitals monthly, and Burns hospital every six weeks, in addition to duties at his main office at St. Charles and visits to a clinic in LaPine. So how does he feel about having to the driving instead of the patients? "I actually enjoy getting out and traveling and meeting people in the different towns," Dr. Stauder said, adding, "I also like fly fishing the Deschutes and Crooked rivers and this is a fun way to mix up my enjoyment of the outdoors with surgery."